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The daily practice of marital and family therapy is replete with family secrets, including such intimate and profound areas of family life as birth, adoption, parentage, infertility, physical and mental illness, sexual orientation, incest, rape, abortion, addictions, divorce and suicide. Such secrets confront the therapist with the need to examine one's own values regarding secrecy and openness, and to devise methodologies that are both ethical and effective.
Ryder et al. (1994) studied this question.